The worse survival outcomes reported for melanoma patients having sentinel node biopsy after lymphoscintigraphy the previous day do not appear to be due to overnight migration of Tc99m-nanocolloid tracer
| Autor: | Mette Schoedt, Else la Cour Sibbesen, Bo Zerahn, Lisbet Rosenkrantz Hölmich, John F. Thompson, Annette H. Chakera |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Single Photon Emission Computed Tomography Computed Tomography Time Factors 030230 surgery 03 medical and health sciences 0302 clinical medicine Biopsy medicine Humans Radioactive Tracers Melanoma Technetium Tc 99m Aggregated Albumin medicine.diagnostic_test Sentinel Lymph Node Biopsy business.industry General Medicine Sentinel node medicine.disease Survival Rate Oncology Lymphatic Metastasis 030220 oncology & carcinogenesis Surgery Radiology Radiopharmaceuticals Sentinel Lymph Node business Lymphoscintigraphy |
| Zdroj: | European Journal of Surgical Oncology. 47:2450-2453 |
| ISSN: | 0748-7983 |
| Popis: | Introduction It has been reported that the survival of patients having sentinel node (SN) biopsy for melanoma the day after lymphoscintigraphy using Tc99m-nanocolloid is worse than that of patients having lymphoscintigraphy and SN biopsy on the same day [1,2]. A possible explanation suggested is that overnight migration of the tracer from SNs to 2nd-tier nodes occurs, causing failure to remove true SNs. Materials and methods The possibility of overnight tracer migration leading to errors in SN-identification was investigated in 12 patients scheduled for lymphoscintigraphy the day before surgery by repeating SPECT-CT imaging the next morning, before their SN biopsy. The aim was to check whether onward migration of colloid from previously-identified SNs had occurred. Results No significant migration of Tc99m-nanocolloid occurred overnight in any patient. All nodes reported to be SNs on day 1 imaging were also present and regarded as SNs on day 2 images. No new foci were visualised on day 2, but some that had been identified on day 1 were not seen on day 2. Conclusions Since migration of nanocolloid overnight did not occur, this cannot explain the reported survival disadvantage for patients undergoing SN biopsy the day after lymphoscintigraphy. A likely alternative possibility is that inadequate doses of radioisotope were used for next-day procedures, causing the mistaken removal of 2nd-tier nodes instead of true SNs more frequently. Further research is required to explain the reported reduction in survival of patients having next-day SN biopsy procedures, since the possibility has important clinical implications. |
| Databáze: | OpenAIRE |
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